治療成績からみた食道m3・sm癌の治療方針―外科切除例の治療成績：3領域郭清の立場から

Clinical Outcome of Surgical Treatment for m3・sm Esophageal Cancer: A Point of View on Three-field Lymph Node Dissection

要旨　食道m₃・sm癌において，特にリンパ節転移の有無は，選択すべき治療法，また治療成績にも影響する重要な因子である．胸部食道癌では，頸，胸，腹部の3領域へリンパ節転移する可能性が高く，初発転移の段階から同様の傾向が認められた．食道m₃・sm₁癌では，多様性を持った治療法の選択が可能であり，適切な症例の選択により内視鏡治療（5年生存率91.4％）と外科手術（5年生存率93.0％）で同等の成績が得られている．sm_2・3症例では，リンパ節転移頻度，転移領域からみても，3領域リンパ節郭清を伴う外科手術が標準治療と考えており，over allでのsm₂，sm₃の5年生存率はそれぞれ65.8％，63.3％であった．

　The existence of lymph node metastases of m₃, sm₁ esophageal cancer is an important factor in choosing its treatment, and influences the prognosis of the patient. Thoracic esophageal cancer metastasis easily to cervical, thoracic and abdominal lymph nodes, and this tendency has also been shown in its early stage. The treatment varies from case to case in m₃, sm₁ cancer, and similar results have been achieved by adequate choice of treatment both in endoscopic (5 year survival : 91.4％) and surgical (5 year survival : 93.0％) treatment. Judging by the frequency and mode of lymph node metastasis, surgical treatment is regarded as the treatment of choice in sm₂ and sm₃ cancer, and the 5-year survival rate of sm₂, sm₃ cancer victims was, over all, 65.8％ and 63.3％, respectively.